How can we better understand and treat those suffering from schizophrenia and manic-depressive illnesses? This important new book takes us into the world of those suffering from such disorders. Using self descriptions, its emphasis is not on how mental health professionals view sufferers, but on how the patients themselves experience their disorder. A new volume in the International Perspectives in Philosophy and Psychiatry series, this book will be of great interest to all those working with sufferers from such disorders - (...) helping them to better understand their mental lives, and providing important insights into how best to treat them. (shrink)

The Philosophy of Sociality offers new ideas and conceptual tools for philosophers and social scientists in their analysis of the social world.

This paper argues for psychological realism in the conception of psychiatric disorders. We review the following contemporary ways of understanding the future of psychiatry: (1) psychiatric classification cannot be successfully reduced to neurobiology, and thus psychiatric disorders should not be conceived of as biological kinds; (2) psychiatric classification can be successfully reduced to neurobiology, and thus psychiatric disorders should be conceived of as biological kinds. Position (1) can lead either to instrumentalism or to eliminativism about psychiatry, depending on whether psychiatric (...) classification is regarded as useful. Position (2), which is inspired by the growing interest in neuroscience within scientific psychiatry, leads to biological realism or essentialism. In this paper we endorse a different realist position, which we label psychological realism. Psychiatric disorders are identified and addressed on the basis of their psychological manifestations which are often described as violations of epistemic, moral or social norms. A couple of examples are proposed by reference to the pathological aspects of delusions, and the factors contributing to their formation. (shrink)

Delusional beliefs have sometimes been considered as rational inferences from abnormal experiences. We explore this idea in more detail, making the following points. Firstly, the abnormalities of cognition which initially prompt the entertaining of a delusional belief are not always conscious and since we prefer to restrict the term “experience” to consciousness we refer to “abnormal data” rather than “abnormal experience”. Secondly, we argue that in relation to many delusions (we consider eight) one can clearly identify what the abnormal cognitive (...) data are which prompted the delusion and what the neuropsychological impairment is which is responsible for the occurrence of these data; but one can equally clearly point to cases where this impairments is present but delusion is not. So the impairment is not sufficient for delusion to occur. A second cognitive impairment, one which impairs the ability to evaluate beliefs, must also be present. Thirdly (and this is the main thrust of our chapter) we consider in detail what the nature of the inference is that leads from the abnormal data to the belief. This is not deductive inference and it is not inference by enumerative induction; it is abductive inference. We offer a Bayesian account of abductive inference and apply it to the explanation of delusional belief. (shrink)

Fricker shows that virtue epistemology provides a general epistemological idiom in which these issues can be forcefully discussed.

Knowledge in a Social World offers a philosophy for the information age. Alvin Goldman explores new frontiers by creating a thoroughgoing social epistemology, moving beyond the traditional focus on solitary knowers. Against the tides of postmodernism and social constructionism Goldman defends the integrity of truth and shows how to promote it by well-designed forms of social interaction. From science to education, from law to democracy, he shows why and how public institutions should seek knowledge-enhancing practices. The result is a bold, (...) timely, and systematic treatment of the philosophical foundations of an information society. (shrink)

In recent years, there has been much focus on the apparent heterogeneity of schizophrenic symptoms. By contrast, this article proposes a unifying account emphasizing basic abnormalities of consciousness that underlie and also antecede a disparate assortment of signs and symptoms. Schizophrenia, we argue, is fundamentally a self-disorder or ipseity disturbance that is characterized by complementary distortions of the act of awareness: hyperreflexivity and diminished self-affection. Hyperreflexivity refers to forms of exaggerated self-consciousness in which aspects of oneself are experienced as akin (...) to external objects. Diminished self-affection or self-presence refers to a weakened sense of existing as a vital and self-coinciding source of awareness and action. This article integrates recent psychiatric research and European phenomenological psychiatry with some current work in cognitive science and phenomenological philosophy. After introducing the phenomenological approach along with a theoretical account of normal consciousness and self-awareness, we turn to a variety of schizophrenic syndromes. We examine positive, then negative, and finally disorganization symptoms—attempting in each case to illuminate shared distortions of consciousness and the sense of self. We conclude by discussing the possible relevance of this approach for identifying early schizophrenic symptoms. (shrink)

Objective: The clinical hallmark of schizophrenia is psychosis. The objective of this overview is to link the neurobiology (brain), the phenomenological experience (mind), and pharmacological aspects of psychosis-in-schizophrenia into a unitary framework. -/- Method: Current ideas regarding the neurobiology and phenomenology of psychosis and schizophrenia, the role of dopamine, and the mechanism of action of antipsychotic medication were integrated to develop this framework. -/- Results: A central role of dopamine is to mediate the "salience" of environmental events and internal representations. (...) It is proposed that a dysregulated, hyperdopaminergic state, at a "brain" level of description and analysis, leads to an aberrant assignment of salience to the elements of one's experience, at a "mind" level. Delusions are a cognitive effort by the patient to make sense of these aberrantly salient experiences, whereas hallucinations reflect a direct experience of the aberrant salience of internal representations. Antipsychotics "dampen the salience" of these abnormal experiences and by doing so permit the resolution of symptoms. The antipsychotics do not erase the symptoms but provide the platform for a process of psychological resolution. However, if antipsychotic treatment is stopped, the dysregulated neurochemistry returns, the dormant ideas and experiences become reinvested with aberrant salience, and a relapse occurs. -/- Conclusions: The article provides a heuristic framework for linking the psychological and biological in psychosis. Predictions of this hypothesis, particularly regarding the possibility of synergy between psychological and pharmacological therapies, are presented. The author describes how the hypothesis is complementary to other ideas about psychosis and also discusses its limitations. (shrink)

In the 2000s, several psychiatrists cited the lack of relational disorders in the DSM-IV as one of the two most glaring gaps in psychiatric nosology, and campaigned for their inclusion in the DSM-5. This campaign failed, however, presumably in part due to serious “ontological concerns” haunting such disorders. Here, I offer a path to quell such ontological concerns, adding to previous conceptual work by Jerome Wakefield and Christian Perring. Specifically, I adduce reasons to think that collective disorders are compatible with (...) key metaphysical commitments of contemporary scientific psychiatry, and argue that if one accepts the existence of mental disorders in individuals as medical, then one has good reasons to accept the existence of collective disorders as medical. First, I outline how collective disorders are reconcilable with both the harmful dysfunction model of disorder and a denial of mind-body dualism. I then identify some potential weaknesses in the main pre-existing example of a collective disorder, offering my own examples as supplements. These examples’ medical plausibility is bolstered by: work in philosophy of biology on the generalized selected effects theory of function, and work in analytic philosophy of mind on collective mentality. Finally, after offering preliminary responses to the objection that the recognition of collective disorders may lead to an overpathologization of everyday life, I spell out ways in which this recognition may have empowering effects for some would-be patients; for example, by providing substance to the notion of a “sane response to an insane world.”. (shrink)

This work provides a rigorous analysis of what Tuomela calls ‘the we-perspective’. Tuomela's overarching project is to argue that ‘conceptualizing social life and theorizing about it requires the use of group concepts, indeed the we-perspective and, especially, the we-mode.’ Already some of the complexities of Tuomela's approach will be evident – viz. in the distinction, implied in the above quotation and carried through systematically throughout the work, between the ‘we-perspective’ and the ‘we-mode’. For, indeed, it is possible, on his account, (...) to take up the we-perspective from the I-mode and, indeed, this is probably quite common, but is not adequate to ground the analysis of social and institutional concepts. As Tuomela puts it, ‘The concept of social institution is a we-mode concept, and in actual practice, at least some we-mode thinking and acting is required for institutions to function adequately.’ Since ‘we-mode’ is the more central notion, let us begin with that. It will be instructive to quote Tuomela at length : " Agent A, a member of group g, has ATT, the attitude ATT with content p, in … ". (shrink)

Ever since Plato, philosophers have faced one central question: what is the scope and nature of human knowledge? In this volume the distinguished philosopher Ernest Sosa collects essays on this subject written over a period of twenty-five years. All the major topics of contemporary epistemology are covered: the nature of propositional knowledge; externalism versus internalism; foundationalism versus coherentism; and the problem of the criterion. 'Sosa is one of the most prominent and most important epistemologists on the current American scene.' William (...) P. Alston, Syracuse University. (shrink)

Article copyright 2002. We provide a battery of examples of delusions against which theoretical accounts can be tested. Then we identify neuropsychological anomalies that could produce the unusual experiences that may lead, in turn, to the delusions in our battery. However, we argue against Maher's view that delusions are false beliefs that arise as normal responses to anomalous experiences. We propose, instead, that a second factor is required to account for the transition from unusual experience to delusional belief. The second (...) factor in the etiology of delusions can be described superficially as a loss of the ability to reject a candidate for belief on the grounds of its implausibility and its inconsistency with everything else that the patient knows, but we point out some problems that confront any attempt to say more about the nature of this second factor. (shrink)

Delusions play a fundamental role in the history of psychology, philosophy and culture, dividing not only the mad from the sane but reason from unreason. Yet the very nature and extent of delusions are poorly understood. What are delusions? How do they differ from everyday errors or mistaken beliefs? Are they scientific categories? In this superb, panoramic investigation of delusion Jennifer Radden explores these questions and more, unravelling a fascinating story that ranges from Descartes’s demon to famous first-hand accounts of (...) delusion, such as Daniel Schreber’s Memoirs of My Nervous Illness. Radden places delusion in both a clinical and cultural context and explores a fascinating range of themes: delusions as both individually and collectively held, including the phenomenon of folies á deux ; spiritual and religious delusions, in particular what distinguishes normal religious belief from delusions with religious themes; how we assess those suffering from delusion from a moral standpoint; and how we are to interpret violent actions when they are the result of delusional thinking. As well as more common delusions, such as those of grandeur, she also discusses some of the most interesting and perplexing forms of clinical delusion, such as Cotard and Capgras. (shrink)

Although psychologists have paid scant attention to the sense of obligation as a distinctly human motivation, moral philosophers have identified two of its key features: First, it has a peremptory, demanding force, with a kind of coercive quality, and second, it is often tied to agreement-like social interactions in which breaches prompt normative protest, on the one side, and apologies, excuses, justifications, and guilt on the other. Drawing on empirical research in comparative and developmental psychology, I provide here a psychological (...) foundation for these unique features by showing that the human sense of obligation is intimately connected developmentally with the formation of a shared agent “we,” which not only directs collaborative efforts but also self-regulates them. Thus, children's sense of obligation is first evident inside, but not outside, of collaborative activities structured by joint agency with a partner, and it is later evident in attitudes toward in-group, but not out-group, members connected by collective agency. When you and I voluntarily place our fate in one another's hands in interdependent collaboration – scaled up to our lives together in an interdependent cultural group – this transforms the instrumental pressure that individuals feel when pursuing individual goals into the pressure that “we” put on me to live up to our shared expectations: a we > me self-regulation. The human sense of obligation may therefore be seen as a kind of self-conscious motivation. (shrink)

The fact that much of our knowledge is gained through the testimony of others challenges a certain form of epistemic individualism. We are clearly not autonomous knowers. But the discussion surrounding testimony has maintained a commitment to what I have elsewhere called epistemic agent individualism. Both the reductionist and the anti-reductionist have focused their attention on the testimony of individuals. But groups, too, are sources of testimony - or so I shall argue. If groups can be testifiers, a natural question (...) to ask is whether our beliefs based on the testimony of groups are ever justified and whether such a justification is to be conferred inferentially or non-inferentially. I consider and dismiss the possibility of extending an anti-reductionist account of justification to our group testimonial beliefs. I also argue against a version of reductionism that would have our group testimonial beliefs justified only in so far as we were able to monitor the trustworthiness of members of the group. However, there are forms of reductionism that can be extended to make sense of the justification of our group testimonial beliefs. There are mechanisms for monitoring the trustworthiness and competency of a group (rather than its members) and, further, a variety of background beliefs allow us to assess the testimony of a group for reliability. (shrink)

Circumscribed delusional beliefs can follow brain injury. We suggest that these involve anomalous perceptual experiences created by a deficit to the person's perceptual system, and misinterpretation of these experiences due to biased reasoning. We use the Capgras delusion (the claim that one or more of one's close relatives has been replaced by an exact replica or impostor) to illustrate this argument. Our account maintains that people voicing this delusion suffer an impairment that leads to faces being perceived as drained of (...) their normal affective significance, and an additional reasoning bias that leads them to put greater weight on forming beliefs that are observationally adequate rather than beliefs that are a conservative extension of their existing stock. We show how this position can integrate issues involved in the philosophy and psychology of belief, and examine the scope for mutually beneficial interaction. (shrink)

Within social psychology, group identification refers to a mental process that leads an individual to conceive of herself as a group member. This phenomenon has recently attracted a great deal of attention in the debate about shared agency. In this debate, group identification is appealing to many because it appears to explain important forms of intentionally shared actions in a cognitively unsophisticated way. This paper argues that, unless important issues about group identification are not illuminated, the heuristic function ascribed to (...) this notion for an understanding of shared agency remains dubious at best and unfulfilled at worst. This paper offers such a clarification by distinguishing and describing two different mental processes that constitute group identification: adoption of the group perspective and transformation in self-understanding. It is claimed that the latter process consists in the production of what Ruth Millikan labels “Pushmi-Pullyu representations” and that it is developmentally prior with respect to the ability of adopting the group perspective. (shrink)

Philosophers have proposed accounts of shared intentions that aim at capturing what makes a joint action intentionally joint. On these accounts, having a shared intention typically presupposes cognitively and conceptually demanding theory of mind skills. Yet, young children engage in what appears to be intentional, cooperative joint action long before they master these skills. In this paper, I attempt to characterize a modest or ‘lite’ notion of shared intention, inspired by Michael Bacharach’s approach to team–agency theory in terms of framing, (...) group identification and team reasoning. I argue that the account of shared intentions this approach yields is less cognitively and conceptually demanding than other accounts and is thus applicable to the intentional joint actions performed by young children. I also argue that it has limitations of its own and that considering what these limitations are may help us understand why we sometimes need to take other routes to shared intentions. (shrink)

Social epistemology is the study of the social dimensions of knowledge or information. There is little consensus, however, on what the term "knowledge" comprehends, what is the scope of the "social", or what the style or purpose of the study should be. According to some writers, social epistemology should retain the same general mission as classical epistemology, revamped in the recognition that classical epistemology was too individualistic. According to other writers, social epistemology should be a more radical departure from classical (...) epistemology, a successor discipline that would replace epistemology as traditionally conceived. The classical approach could be realized in at least two forms. One would emphasize the traditional epistemic goal of acquiring true beliefs. It would study social practices in terms of their impact on the truth-values of agents’ beliefs. A second version of the classical approach would focus on the epistemic goal of having justified or rational beliefs. Applied to the social realm, it might concentrate, for example, on when a cognitive agent is justified or warranted in accepting the statements and opinions of others. Proponents of the anti-classical approach have little or no use for concepts like truth and justification. In addressing the social dimensions of knowledge, they understand "knowledge" as simply what is believed, or what beliefs are "institutionalized" in this or that community, culture, or context. They seek to identify the social forces and influences responsible for knowledge production so conceived. Social epistemology is theoretically significant because of the central role of society in the knowledge-forming process. It also has practical importance because of its possible role in the redesign of information-related social institutions. (shrink)

Jennifer Radden argues that delusions play an important role in modernist epistemology, which is preoccupied with the justification and evaluation of beliefs. Another theme running through the book is the importance of culture for attribution of delusion. Beliefs that look delusional will not be treated as pathological if they are expressions of religious views or other culturally acceptable forms of life. It is hard to see why cultural acceptability should play a role in the modernist project of justification. I suggest (...) that we think less about a philosophical project of justification and turn our attention instead to commonsense judgements of the circumstances in which we see a belief as evidence of underlying pathology. I discuss cases in which unjustified beliefs are nonetheless treated as phenomena that are consistent with our views of how healthy human beings act, and suggest that alongside folk psychology we should acknowledge a folk epistemology that embraces such instances. I suggest that delusions are beliefs that folk epistemology treats as inexplicable, and that this approach solves some of the puzzles that Radden identifies as growing out of the modernist epistemic project. (shrink)

In folie à deux, a ‘primary’ patient transmits a delusional belief to one or more ‘secondary’ patients who then adopt and share the belief. This paper applies the two‐factor theory of delusion to retrospectively analyse published cases of folie à deux. Lessons from this retrospective analysis include, firstly, that two‐factor theorists need to shift their focus from endogenous processes to consider the exogenous source of delusional content in most secondaries. Secondly, secondaries who come to share the belief via normal processes (...) of social contagion only qualify as delusional by virtue of the abnormal persistence of their belief, albeit a temporary persistence in those secondaries who abandon their belief soon after separation from the primary. Underpinning this abnormal persistence may be a form of inhibitory failure—a difficulty with inhibiting a belief to allow reasoning for and against it being true. (shrink)

Some delusional patients exhibit only a single delusional belief (or several delusional beliefs concerning a single theme): this is monothematic delusion. It contrasts with polythematic delusion, where the patient exhibits a variety of delusions concerning a variety of different themes. The neuropsychological bases of various monothematic delusions are rather well understood, and there is a well-worked-out general neuropsychological theory of monothematic delusion, the two-factor theory. Whether polythematic delusion might be explained in a similar way is an open question: I sketch (...) some possible ways in which a comparable two-factor account might be developed for polythematic (‘psychiatric’) delusional conditions such as delusions of reference. (shrink)

Chapter discussing the relationship between rationality and sanity.

Madness and Modernism provides a phenomenological study of schizophrenic disorders, criticizing some standard conceptions of these disorders. Sass argues that many aspects of this group of disorders can actually involve more sophisticated (albeit dysfunctional) forms of mind and experience.

Delusions are a common symptom of schizophrenia and dementia. Though most English dictionaries define a delusion as a false opinion or belief, there is currently a lively debate about whether delusions are really beliefs and indeed, whether they are even irrational. The book is an interdisciplinary exploration of the nature of delusions. It brings together the psychological literature on the aetiology and the behavioural manifestations of delusions, and the philosophical literature on belief ascription and rationality. The thesis of the book (...) is that delusions are continuous with ordinary beliefs, a thesis that could have important theoretical and practical implications for psychiatric classification and the clinical treatment of subjects with delusions. By bringing together recent work in philosophy of mind, cognitive psychology and psychiatry, the book offers a comprehensive review of the philosophical issues raised by the psychology of normal and abnormal cognition, defends the doxastic conception of delusions, and develops a theory about the role of judgements of rationality and of attributions of self-knowledge in belief ascription. Presenting a highly original analysis of the debate on the nature of delusions, this book will interest philosophers of mind, epistemologists, philosophers of science, cognitive scientists, psychiatrists, and mental health professionals. (shrink)

In various ways, schizophrenia seems to involve an anomalous form of collective intentionality. Many patients report notable difficulties in establishing and maintaining relationships to others, which often may lead to social withdrawal, isolation, and pro-found feelings of solitude. What is puzzling is of course not that patients, despite their interpersonal difficulties, participate in or try to participate in various social activities, but that some of these social activities appear quite tolerable to the patients, whereas other activities seem almost unbearable. The (...) aim of this paper is to shed light on this aberrant social behaviour by clarifying the relations between schizophrenia and collective intentionality. (shrink)

This is a revision of game theory which takes account of agents' own descriptions of their situations, and which allows people to reason as members of groups.